Our clients consult with us on a daily basis to discuss some of their most pressing questions about travel health and potential medical issues that could arise while their travelers are abroad. In this Q+A, our Medical Director, Dr. Michelle Nathan, shares answers to some of our favorite questions, including advice, resources, and strategies to help keep your travelers safe, healthy, and well informed.

What are some medications that are legal in the U.S. but illegal in other countries? How do travelers adapt?
Dr. Nathan: Scheduled substances are often banned or very restricted in other countries. This includes medications for ADHD, chronic pain, and anxiety. However, there are also some common medications that are banned in other countries (certain asthma inhalers in Japan, as an example). Unfortunately, there is no central resource that provides this information. Travelers should contact the embassy/consulate for their destination to ask about local laws regarding medications, check the country’s tourism website, and consider looking on credible travel blogs for specific medications. In cases where their medication is banned, travelers should talk to their doctors about possible alternatives or the feasibility of travel. If a traveler is planning to change medications, it is very important they do so before travel. This allows time to adjust and avoid any ‘surprises’ from their medications while they are abroad.

What advice do you have for travelers to stay on their medication schedules with time zone changes?
Dr. Nathan: Some medications are much more time-sensitive than others. For brief trips with small time zone changes, travelers can stay on ‘home time’ by keeping a watch on their usual home time and taking their medication as they normally would at home. For medications with slightly less time sensitivity, travelers can take the medication at the same local time as they would at home (meaning if they usually take a medication at 10pm at home, they would take it at 10pm local time in their destination). For longer trips, travelers can consider gradually changing their medication times so they match the local time of their destination by the time they travel. For example, an individual could change their medication time by 15 minutes each day until they are on their destination’s time. Travelers should be sure to discuss their medications with their doctors and/or pharmacists before adjusting their schedules.

What advice do you have to help travelers be prepared for an emergency medication refill?
Dr. Nathan: When abroad, it may be difficult to get a refill locally. It is good practice for individuals to travel with a list of their medications, copies of all their prescriptions, and a letter from their doctors explaining their medical conditions and the medications they take for those conditions. An individual’s greatest resource is their travel risk management company, which can work with them to get emergency refills.

How should someone with mental illness prepare for travel?
Dr. Nathan: Travelers should meet with their mental health providers to address stressors they could encounter, coping mechanisms, and possible remote counseling if needed. Travelers should have a primer that details the journey, the culture and expected demands during travel, and the travel environment; this primer can be reviewed with their mental health professional. A care plan can be drafted in advance of travel. It can include resources in the travel area – or in the setting of group travel, potentially having a medical resource travel with the group.

How should someone with a chronic medical condition (such as asthma, diabetes, Crohn’s, etc.) prepare to manage their health abroad?
Dr. Nathan: A traveler should have their chronic condition well-managed and controlled before embarking on a trip. They should be sure to have enough of their medications with them; it’s a good idea to take more than needed just in case their return home is delayed. While traveling, individuals should maintain their usual habits of diet, exercise, and sleep. Travelers can check the U.S. Embassy site or with their travel risk management provider for healthcare facilities at their destinations. Finally, ensure travelers have appropriate healthcare and assistance coverage for their trips in case they need medical attention.

If a traveler has had anxiety in the past, but hasn’t had any episodes for years, should they incorporate plans for addressing potential challenges with their anxiety into their pre-travel preparations?
Dr. Nathan: One of the most prevalent issues during travel abroad tends to occur with anxiety. Being abroad is inherently stressful. Fatigue from travel, changes in daily structure, unfamiliar customs and language, loss of familiar contexts (friends, places), and isolation can all trigger an acute mental health episode. Being prepared and having a plan before issues develop is key. Despite not having had any recent episodes of anxiety, it is probably worthwhile for travelers to meet with a mental health professional and take some of the steps outlined in question four.

What if a traveler has a medication that they’ve been prescribed to treat a condition, but they only have to take it as necessary? If a medication isn’t in a traveler’s daily routine, should they plan to bring the medication when they travel? How easy will it be to get the medication abroad ?
Dr. Nathan: It is best for individuals to travel with all their medications, even those they take on an ‘as-needed’ basis, as it can be extremely difficult to obtain medication abroad.

Do you or your travelers have more burning questions about travel health and holistic risk management? Contact us today!

What’s Happening Now

Author: Jacob Newton The establishment and maintenance of an effective Travel Risk Management (TRM) program is a task that requires the attention and involvement of several stakeholders in order to meet the desired outcome: the safety of the travelers it’s intended to protect. Furthermore, it can be tempting to implement a variety of available solutions…

If you are on your trip and have an emergency, please contact our 24/7
Global Response Center at (800) 575-5014 (toll free U.S. or Canada) or
(603) 328-1926 (anywhere in the world). You can also email us for
emergencies at mail@oncallinternational.com